T Nation

HIV Misconceptions and Government Paternalism


#1

I've been writing about this subject and was wondering what the T-Nation take would be.

HIV is a relatively difficult disease to contract, especially heterosexually. In the developed world, the chance of transmission from a positive woman to a negative man via unprotected vaginal intercourse is estimated to be about 1 in 2,000; male-to-female is more efficient for obvious reasons but is still not nearly as likely as most people believe.

Those figures are variable and increase during early and late stages of infection and with concurrent STDs, but they are essentially solid and supported by a wide body of evidence spanning decades. In short, it is statistically likelier that you will be struck by lightning at some point in your life than that you will contract HIV after an unprotected encounter with a seropositive woman.

For common-sense reasons, health professionals do not actively distribute this information. In fact, it is common to instruct specialists and educators to imply that HIV is highly transmissible in all circumstances. Advertising campaigns, health books, and schoolroom curricula tend to approach the subject in the same way. Consequently, studies routinely show that people greatly overestimate the virus' transmissibility.

I am predisposed to believe that the truth always trumps even the most convenient and innocuous falsities. I am also predisposed to resist government paternalism.

But in this case, knowing that people are extremely stupid and have a very tenuous understanding of statistics and risk, and knowing that with enough precaution the virus can be decimated in a single generation, I am happy that the public is misinformed.

Thoughts?


#2

What you have written is spot on. And let's not forget the enormous profitability of ARVs to pharma companies as a motivating factor to keep the disease in the spotlight as 'highly transmissible'. Personally I know quite a few people that have done arv courses after an unprotected heterosexual encounter, justa as a precautionary measure. Of course that is purely anecdotal.


#3

The drug companies has to be a huge chunk of it. Look at the tactics they are using with the shingles vaccine.


#4

From what I've read, precautionary treatment is unwarranted in most cases, given the low probability of seroconversion even if the partner in question is known to be positive (I'm speaking about heterosexual sex here). Though, when I was in Ghana, I knew a guy who had unprotected sex with a prostitute. In his case it seemed like a good idea, God knows I would've wanted to be on meds too if I had done something so monumentally stupid. As far as I know he didn't end up testing positive.

I'm sure that fears are only amplified in South Africa, where I believe nearly half of deaths are AIDS-related.


#5

Yes, the use of the precautionary course IS unwarranted in the heterosexual context. Doesn't stop the doctor from prescribing it though. That's my point. A very wise old doctor , my GP way back when, gave me the lowdown when I approached him with my concerns about 18 or 19 years (give or take,was a long time back) ago in this respect, as I was doing my fair share of shagging around. I remember the conversation like It was the other day. He asked me if I was A) an intravenous drug user,
B) Gay
C) Screwing prostitutes

The answer to all three was no, so he told me: If you want to live a long life, the best advice I can give you is don't smoke and wear your seatbelt. Other than that lead your life and stop stressing, the odds are miniscule.


#6

I had a doctor tell me something similar. I mentioned that the only really questionable contact I ever had was a single encounter when I was seventeen. I made it sound worse than it was just to be conservative about it, told him I had reason to believe she'd been around quite a bit, etc. He said that testing would be a waste of time.

But, here's the real question: is it best that not many people understand this? The truth is that a single act of vaginal intercourse with a woman known to be seropositive is highly unlikely to result in infection. It's true, so it has that going for it, but it could also lead to a complacency that is remarkably dangerous. 1 in 2,000 is great comfort to those who have slipped up a single time, but extrapolate that over an entire libidinous population and it's easy to understand why heterosexual sex is now the most common mode of transmission worldwide.

In other words, is this one situation in which widespread misconception is to be left alone, even celebrated?


#7

I think that more information is always better than less, and that people are going to get it on no matter what. Truth is HIV, while tragic and certainly prevalent in certain areas of the world, like SA, is not the wildfire plague or epidemic it was being touted as being in the Western world. As a virus it is rather inefficient, as was stated earlier.

But in low education societies ,like Africa, the lies makes no difference. Sex is one of the few pleasures the poor can indulge in same as the wealthy. And they do. Without protection. No matter what the official stance is. It is more a socio economic problem in these places. When you're hungry and living a threadbare existence for peanuts, condoms are the furthest thing from your mind. In Africa contraception should be the rule not to primarily curb HIV, but to slow population growth which just increases the poverty.


#8

I mean people continue to smoke regardless...or get obese, eat totally shit diets etc etc....the brutal truth doesn't stop people from making bad choices even when it's dire, so I don't see the benefit of the lie.


#9

Well put. I tend to agree, especially re: Africa. I am still conflicted about it here in the US. I have to admit that I'm happy some of my more idiotic friends greatly overestimate the risk HIV acquisition, because that still only stops them half the time.


#10

HIV positive people must be fucking like rabbits then.


#11

People in general are fucking like rabbits. Always have been.


#12

Right but 1 in 2,000 requires a shit load of new partners...


#13

I just opened this thread, thinking it must have been bumped or something, with nearly 200 posts. Nope, it was posted less than 24 hours ago. This should be good. Guess it'll be over 400 posts before I finally make it to this one.


#14

Can be the same partner over time. Doesn't have to be a new one each time.


#15

Never mind, I feel like an ass.

I must have been looking at the thread just below or above this.


#16

Anal sex.


#17

As smh mentioned about the variability of different people to spread the virus. I wonder if research is being done on why some people may spread it "better" vs people that are positive yet unable to or at least relatively less those that are "better", this also should be applied to people that are more or less susceptible and why that is.


#18

A number of factors are known to influence this variability: stage of the virus (early and late make it easy to transmit because it is more concentrated in fluids; middle-stage the concentration can be close to undetectable and it is therefore less transmissible), presence of ulcers from other STDs, circumcision seems to provide some protection. Low-income and undeveloped countries see a much higher rate of transmission for a variety of reasons. There is also a gene, found in almost exclusively in people of northern European descent, which can diminish or even eliminate its carrier's ability to contract the virus.